Matthew Walter Jaenicke M.D.

NPI 1063892008 - Internal Medicine - 207R00000X

NPI Details
NPI 1063892008
Gender Male
Enumeration Date 06/04/2015
Last Updated 06/04/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
169 ASHLEY AVE
ROOM 202 MAIN HOSPITAL, MSC 333
CHARLESTON SC, 29425-8905, US
Phone (843) 792-2911
Fax
Business Location
169 ASHLEY AVE
ROOM 202 MAIN HOSPITAL, MSC 333
CHARLESTON SC, 29425-8905, US
Phone (843) 792-2911
Fax
Toxanomy
Taxonomy Code 207R00000X
License State South Carolina
License Number LL38299
Remove 1063892008 NPI Number
 

According to our database, Matthew Walter Jaenicke M.D. NPI is 1063892008, taxonomy code is 207R00000X and license number is LL38299, license state is located at South Carolina. Matthew Walter Jaenicke M.D. physically located at 169 Ashley Ave, Charleston SC, 29425-8905. NPI Number Matthew Walter Jaenicke M.D. has the Individual type.

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1063892008 NPI number is provided on an as is basis without warranty of any kind. 1063892008 is maintained by the National Plan & Provider Enumeration System. The contents of Matthew Walter Jaenicke M.D. are for informational purposes only.